REPUBLIC OF ZAMBIA
Designs Form No. 27
Section 6 (2)
Regulation 30
THE REGISTERED DESIGNS ACT
Fee unit: 1
REQUEST FOR GENERAL CERTIFICATE OF THE REGISTRAR
Design No.
, registered in the name of ......................................
I/We
of
hereby request the Registrar to furnish me/us with (1) his certificate that (2)
(1) a certificate of registration of the design (1) for use in obtaining registration abroad.
Dated this
day of ............................................, 19 ...............
(3)
The Registrar,
The Designs Office,
Lusaka,
Zambia.
(1) Delete
words that
are not
applicable
(2) Here
set out the
particulars
which the
Registrar
is
requested
to certify
(3) To be
signed by
the
applicant(s)
or his/their
agent